
function initialize(){
	content = '<div id=content_id class=content>'
	content += '<div id=inner_content_id class=inner_content>'

	content += '<table>'
	content += 		add_input('Today\'s Date : ', 'date_id', '<tr>','</tr>')
	content += 		add_input('Name : ', 'name_id', '<tr>','')
	content += 		add_input('Phone : ', 'phone_id', '','</tr>')
	content += 		add_input('Address : ', 'address_id', '<tr>','')
	content += 		add_input('Zip : ', 'zip_id', '','</tr>')
	content += 		add_input('Birthday : ', 'birth_id', '<tr>','')
	content += 		add_input('Occupation : ', 'occupation_id', '','</tr>')
	content += 		add_input('Emergency Contact : ', 'eContact_id', '<tr>','')
	content += 		add_input('Contact Phone : ', 'eContact_phone_id', '','</tr>')
	content += add_text_area('Your primary health concerns: What brings you for treatment?','prime_concern_id', '<tr>','</tr>')
	title = 'Hospitalizations: surgeries, major injuries, or trauma. Please list what and when.'
	content += add_text_area(title,'hosp_id', '<tr>','</tr>')
	content += add_text_area('Medications and Supplements','meds_id', '<tr>','</tr>')

	title = 'HEALTH HISTORY: HAVE YOU HAD OR DO YOU CURRENTLY HAVE THE FOLLOWING'
	content += addTitle(title,'hist_id', '<tr>','</tr>')
	content += add_checkbox('Epilepsy/Seizures','1', '<tr>','')
	content += add_checkbox('Cancer','2','','')
	content += add_checkbox('HIV+','2','','')
	content += add_checkbox('Stroke','2','','</tr>')

	content += add_checkbox('Anemia','2','<tr>','')
	content += add_checkbox('Addiction','2','','')
	content += add_checkbox('Hepatitis A/B/C','2','','')
	content += add_checkbox('Osteoporosis','2','','</tr>')

	content += add_checkbox('Bleeding','2','<tr>','')
	content += add_checkbox('Asthma','2','','')
	content += add_checkbox('Thyroid disorder','2','','')
	content += add_checkbox('Autoimmune','2','','</tr>')

	content += add_checkbox('Heart Disease','2','<tr>','')
	content += add_checkbox('Diabetes','2','','')
	content += add_checkbox('Tuberculosis','2','','')
	content += add_checkbox('Pacemaker','2','','</tr>')

	content += add_checkbox('Bronchitis','2','<tr>','')
	content += add_checkbox('Pneumonia','2','','')
	content += add_checkbox('Osteoporosis','2','','')
	content += add_checkbox('Allergies','2','','</tr>')

	content += '</table>'

	content += '</div></div>'
	document.getElementById('web_content').innerHTML = content
}

